A novel method to enable biventricular defibrillator to biventricular pacemaker downgrade involving DF4 defibrillator lead Arnoldas Giedrimas, MD, FHRS,

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Presentation transcript:

A novel method to enable biventricular defibrillator to biventricular pacemaker downgrade involving DF4 defibrillator lead Arnoldas Giedrimas, MD, FHRS, Brian Sisson, MS, David Casavant, MS HeartRhythm Case Reports Volume 4, Issue 12, Pages 598-600 (December 2018) DOI: 10.1016/j.hrcr.2018.09.006 Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 1 Schematic showing IS1 right ventricular (RV) lead, IS1 left ventricular (LV) lead, and DF4 RV lead aligned before insertion into the model U128 CRT-P (Boston Scientific, Marlborough, MA). Note that the RV and LV leads are reversed. RA = right atrium. HeartRhythm Case Reports 2018 4, 598-600DOI: (10.1016/j.hrcr.2018.09.006) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 2 Pictorial showing subtle difference in DF4 and IS4 connectors. DF4 pin stepdown is designed to prevent insertion of IS4 into the DF4 connector because it presents the dangerous possibility of shock delivery through pace/sense (P/S) electrodes. However, insertion of a DF4 lead into an IS4 connector port is not restricted, and there is no risk of delivering a high-voltage shock through low-voltage pacing electrodes. Note that superior vena cava (SVC) and right ventricular (RV) correspond to DF4 coil connections; and P/S+ and P/S– of the DF4 lead map to E1 and E2 of the IS4 lead. HeartRhythm Case Reports 2018 4, 598-600DOI: (10.1016/j.hrcr.2018.09.006) Copyright © 2018 Heart Rhythm Society Terms and Conditions